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胰岛素增敏剂与他汀类药物对非酒精性脂肪性肝病患者代谢指标及超声评分的比较效应

Comparative Effect of Insulin Sensitizers and Statin on Metabolic Profile and Ultrasonographical Score in Non Alcoholic Fatty Liver Disease.

作者信息

Rana Himanshu, Yadav Suraj Singh, Reddy Himanshu D, Singhal Shubham, Singh Dinesh Kumar, Usman Kauser

机构信息

Junior Resident, Department of Medicine, King George's Medical University , Lucknow, Uttar Pradesh, India .

Senior Resident, Department of Pharmacology, King George's Medical University , Lucknow, Uttar Pradesh, India .

出版信息

J Clin Diagn Res. 2016 Aug;10(8):OC19-23. doi: 10.7860/JCDR/2016/19887.8336. Epub 2016 Aug 1.

Abstract

INTRODUCTION

Non Alcoholic Fatty Liver Disease (NAFLD) is a metabolic disorder involving fat accumulation in the liver. The initial management for patients with NAFLD includes lifestyle modification and weight loss in overweight or obese patients.

AIM

The present study was conducted to compare the efficacy of insulin sensitizers and statin in the patients of NAFLD.

MATERIALS AND METHODS

The study included 98 patients diagnosed with NAFLD on USG (Ultrasonography) abdomen, divided into three Groups randomly and administered Metformin (Group I), Rosuvastatin (Group II) or Pioglitazone (Group III) along with dietary intervention and lifestyle modification. Their Body Mass Index (BMI), liver function tests, fasting lipid profile, USG scores for fatty liver were done and followed up at 4 weeks, 12 weeks and 24 week for change in above parameters.

RESULTS

Out of the three Groups, Group II showed a maximum improvements in usg scores for NAFLD (p<0.001) and fasting lipid profile. Group II also showed maximum derangement of liver enzymes at 24 weeks though none of the subjects had more than three times elevation of liver enzymes.

CONCLUSION

Rosuvastatin may be an effective therapy as add on treatment to dietary and lifestyle intervention in patients of NAFLD. As an add-on treatment Rosuvastatin was superior to Pioglitazone or Metformin and acute decompensation is unlikely with this drug. Metformin was not effective as add on therapy for NAFLD, rather rapid weight loss in short period of time resulted in worsening of hepatic steatosis.

摘要

引言

非酒精性脂肪性肝病(NAFLD)是一种代谢紊乱疾病,涉及肝脏脂肪堆积。NAFLD患者的初始治疗包括生活方式改变以及超重或肥胖患者的体重减轻。

目的

本研究旨在比较胰岛素增敏剂和他汀类药物对NAFLD患者的疗效。

材料与方法

该研究纳入了98例经腹部超声(USG)诊断为NAFLD的患者,随机分为三组,并给予二甲双胍(第一组)、瑞舒伐他汀(第二组)或吡格列酮(第三组),同时进行饮食干预和生活方式改变。测量他们的体重指数(BMI)、肝功能检查、空腹血脂谱、脂肪肝的USG评分,并在4周、12周和24周进行随访,观察上述参数的变化。

结果

在三组中,第二组在NAFLD的USG评分(p<0.001)和空腹血脂谱方面改善最大。第二组在24周时肝酶的紊乱也最大,尽管没有受试者的肝酶升高超过三倍。

结论

瑞舒伐他汀作为NAFLD患者饮食和生活方式干预的附加治疗可能是一种有效的疗法。作为附加治疗,瑞舒伐他汀优于吡格列酮或二甲双胍,且使用该药物不太可能出现急性失代偿。二甲双胍作为NAFLD的附加治疗无效,相反,短期内快速减重导致肝脂肪变性恶化。

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